Severe accidental hypothermia: rewarming strategy using a veno-venous bypass system and a convective air warmer

Byline: A. Brauer (1), H. Wrigge (2), J. Kersten (1), J. Rathgeber (1), W. Weyland (1), H. Burchardi (1) Keywords: Key words Accidental hypothermia; Rewarming strategy; Critical care; Extracorporeal circulation Abstract: Objective: To study a rewarming strategy for patients with severe accidental hypothermia using a simple veno-venous bypass in combination with a convective air warmer. Setting: Eighteen beds in a university hospital intensive care unit. Patients: Four adults admitted with a core temperature less than 30 degC. Hypothermia was caused by alcoholic intoxication in three patients and by drug overdose in one patient. Measurements and main results: All patients were rewarmed by a veno-venous bypass and in three cases a convective air warmer was also used. At a bypass flow rate of 100--300 ml/min the mean increase in core temperature was 1.15 degC/h (Range: 1.1--1.2 degC/h). One patient died 2 days after rewarming as a consequence of a reactivated pancreatitis. The other three patients survived without neurological sequelae. Conclusion: This rewarming technique seems safe and effective and allowed the controlled rewarming of our patients who suffered from severe accidental hypothermia Author Affiliation: (1) Dept. of Anesthesiology, Emergency and Intensive Care Medicine, University of Gottingen, Robert-Koch-Strasse 40, D-37 075 Gottingen, Germany e-mail: abraeue@gwdg.de Tel. + 49--551--39--8826 Fax + 49--551--39--8676, DE (2) Dept. of Anesthesiology and Intensive Care Medicine, University of Bonn, Germany, DE Article note: Received: 15 September 1998 Final revision received: 4 January 1999 Accepted: 11 February 1999